Pyloric Stenosis
last authored: Oct 2009, David LaPierre
Introduction
Pyloric stenosis has an incidence of 1:500, and is more common in males
10% genetically inherited
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis. To get students thinking.
Causes and Risk Factors
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
Symptoms usually arise at 2-4 weeks of age, and are characterized by:
- non-bilious projective vomiting after feeding
- constipation
- alert infant, willing to feed
Physical Exam
The three P's
Palpable mass
Peristalsis
Projectile vomiting
- failure to thrive, wasting
- dehydration
- jaundice
- gastric peristalsis traveling from LUQ to epigastrium
- 'olive sign': olive-shaped mass in centre abdomen
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
hypochloremic metabolic acidosis
Diagnostic Imaging
Ultrasound is the modality of diagnostic choice
Differential Diagnosis
Other causes of vomiting or failure to thrive should be considered.
Treatments
Correct dehydration first; then go to the OR to avoid complications.
Can be done via lapasoscopy.
Slice muscle along stomach; keep submucosa intact
Consequences and Course
The Case of...
Case #2 - a small story wrapping it all up and asking about esp management.
Additional Resources
Topic Development
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